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目的:探讨经腹输卵管结扎术失败原因,为经腹部输卵管结扎提供参考。方法:回顾性总结分析我院在2010年1月至2012年12月期间收治的500例经腹输卵管结扎术患者的临床病例资料,总结患者结扎失败原因并探讨相应的预防措施。结果:本次研究的500例经腹部输卵管结扎术患者,手术失败者15例,手术失败率为3%。经过分析手术失败主要有以下几方面的原因:结扎部位选择不合理,以峡部结扎失败率最低;结扎时间选择不合理,非孕期月经净后3-7天最佳;操作不当误将生理盐水注入输卵管,导致原结扎线滑脱;结扎线选择不合适,结扎线以4号为佳;受术者合并其他疾病,如输卵管炎等;误扎圆韧带。结论:手术是要注意选择合适的结扎部位和合适的手术时间,熟练各项手术操作,对于有剖宫产史、盆腔炎病史的患者,经腹输卵管结扎术失败的原因比较高,手术前要进行仔细检查,从而减少患者的手术后并发症,减小手术带给患者的痛苦。对于剖宫产生育第二胎的产妇,可以考虑在剖宫产手术时进行输卵管结扎手术。
Objective: To investigate the causes of failure of transabdominal tubal ligation and provide reference for tubal ligation through the abdomen. Methods: The clinical data of 500 cases of transabdominal tubal ligation admitted from January 2010 to December 2012 in our hospital were retrospectively analyzed. The causes of failure of ligation were summarized and the corresponding preventive measures were discussed. Results: In this study, 500 patients underwent trans-tubal ligation, 15 patients failed surgery, the failure rate was 3%. After analysis of surgical failure, mainly due to the following reasons: Ligation site selection is unreasonable to the isthmus ligation failure rate; ligation time is not reasonable, non-pregnancy menstrual net 3-7 days after the best; improper operation will be injected into normal saline Fallopian tubes, leading to the original ligation line slippage; inappropriate choice of ligature, ligation line 4 is better; subject to other diseases, such as salpingitis; Conclusion: Surgery should pay attention to select the appropriate site of ligation and the appropriate operation time, proficiency in the operation, for patients with a history of cesarean section, pelvic inflammatory disease, abortion, tubal ligation failed reason is high, preoperative Careful examination to reduce the patient’s postoperative complications and reduce the pain brought to patients by surgery. Cesarean section for the birth of the second child of the mother, you can consider cesarean section during tubal ligation surgery.